Why Are Some Americans Living Shorter Lives Than Others?

New research shows that one segment of the population has lost 5 years of life expectancy

We recently reported that a number of new studies found that American’s long-reliable increases in life expectancy — including a remarkable 30-year average increase in the 20th century — may be slowing, both for baby boomers and younger generations, due to a convergence of factors including obesity, mental health issues and limited access to health care.

Now a closer look at those studies and others has identified a cohort of Americans whose life expectancy is declining, and sharply: the nation’s least-educated white adults, who have lost an average of four years of life expectancy since 1990.

University of Illinois at Chicago public health professor S. Jay Olshansky, author of a study published in a recent issue of the journal Health Affairs, has found that education is at least as important as race in determining one’s life expectancy — on average, he reported, African-Americans and Hispanics with 16 or more years of education live 7.5 and 13.6 years longer, respectively, than whites with less than 12 years of education, while white males with at least 16 years of education live 14.2 years longer than African-American men with fewer than 12 years of education.

Women Who Lost Five Years in Two Decades

White women without a high-school diploma, Olshansky also reported, lost a full five years of life expectancy from 1990 to 2008. Their life expectancy is now 73.5 years, while white women with a college degree have an average expectancy of 83.9 years. Meanwhile, the life expectancy of African-American women without high-school diplomas has surpassed that of similar white women. And white men with a college degree now have a life expectancy of 80.4 years while those without a high school diploma live 67.5 years, a decline of about three years for that group since 1990. (Over all, life expectancy for African-Americans continues to trail whites. Hispanic Americans, on average, outlive both.)

Further analysis of Olshansky’s paper and other research, reported in The New York Times, has reinforced a growing realization that continued gains in life expectancy for the nation’s wealthiest, best-educated citizens are occurring at the same time as its least educated residents’ lifespans are contracting.

Possible explanations cited by experts include obesity, a rise in drug use among less-educated whites, persistently high rates of smoking among less-educated white women, and an increase in the percentage of uninsured families among the least-educated Americans.

How drastic is this drop in life expectancy among less-educated white women? Michael Marmot, director of the Institute of Health Equity in London, told the Times that it rivaled the precipitous seven-year drop in life expectancy among Russian men in the turbulent years following the collapse of the Soviet Union. In 1985, American women placed 14th in life expectancy in worldwide rankings. In 2010, they placed 41st — dead last among all developed nations, based on Human Mortality Database research.

Limited Economic Opportunity and Poor Decisions

Olshansky’s research expands upon other smaller studies raising alarms about American life expectancy results over the past five years. Authors of those reports told the Times that while the new research is persuasive, pinning down the exact causes remains puzzling. “We don’t have a great explanation,” said Harvard economics professor David Cutler, whose 2008 research first called attention to the declines.

More women are giving birth outside of marriage, which could put additional economic pressure on them. And women who do marry tend to pair up with men who have similar levels of education, limiting economic opportunity, and access to health care, for their families. Forty-three percent of adults without a high school diploma also lacked health insurance in 2006, according to the American Cancer Society, up from 35 percent in 1993.

Prescription drug abuse, particularly among white women, has risen since 1990, according to research by University of Colorado professor Richard Miech, and smoking rates among less-educated white (and African-American) women have also increased, even as the rates among men in the same groups continue to decline.

One somewhat positive note is that there is a smaller group of American adults lacking a high school diploma now than in the past — about 12 percent, as opposed to 22 percent in 1990, based on Census Bureau data. But those in that group, Olshansky points out, are worse off than before. The gaps between Americans have only widened, he has written, “and have led to at least two ‘Americas,’ if not multiple others, in terms of life expectancy.”